Multilocular Lesion Research Articles

Fundus-DANet: Dilated Convolution and Fusion Attention Mechanism for Multilabel Retinal Fundus Image Classification

The difficulty of classifying retinal fundus images with one or more illnesses present or missing is known as fundus multi-lesion classification. The challenges faced by current approaches include the inability to extract comparable morphological features from images of different lesions and the inability to resolve the issue of the same lesion, which presents significant feature variances due to grading disparities. This paper proposes a multi-disease recognition network model, Fundus-DANet, based on the dilated convolution. It has two sub-modules to address the aforementioned issues: the interclass learning module (ILM) and the dilated-convolution convolutional block attention module (DA-CBAM). The DA-CBAM uses a convolutional block attention module (CBAM) and dilated convolution to extract and merge multiscale information from images. The ILM uses the channel attention mechanism to map the features to lower dimensions, facilitating exploring latent relationships between various categories. The results demonstrate that this model outperforms previous models in classifying fundus multilocular lesions in the OIA-ODIR dataset with 93% accuracy.

Large and Extensive Multilocular Peritoneal Inclusion Cysts Lack Genomic Alterations and Follow an Indolent Clinical Course Despite Rare Recurrences.

Peritoneal inclusion cysts (PICs) are unilocular or multilocular cystic lesions lined by bland mesothelial cells. While most are small and localized, rare examples may be large or multifocal with diffuse peritoneal involvement, causing clinical and even pathologic concern for malignancy. We examined 20 PIC, including 8 large solitary and 12 multifocal lesions. Solitary PIC were found in 7 female and 1 male patients ranging from 19 to 55 (median: 37) years. Expanded collagenous (n=2) or edematous (n=1) areas were occasionally seen in the septae, and 1 had microscopic foci of myxoid stroma. Four had hobnail cells, and 1 had minor areas of papillary mesothelial hyperplasia. Multifocal PICs occurred in 9 female and 3 male patients ranging from 26 to 80 (median: 53) years. Three showed extensive associated fibrosis with entrapment of preexisting adipose tissue, 2 had areas resembling granulation tissue, and 3 had scattered foci of myxoid stroma. Hobnail cells were present in 9, papillary mesothelial hyperplasia in 2, entrapped single cells in 1, and 2 had areas resembling adenomatoid tumors. Two of the multifocal PICs had limited local recurrences at 18 and 21 months. No patients died of disease. Clonal alterations were not identified in any of the tested PICs (mutational and fusion analysis in 5, chromosomal microarray in 1). Despite limited local recurrences, we demonstrate that even large and multifocal PICs may lack identifiable genomic alterations and are associated with benign outcomes.

Case series multilocular cystic hemangioma of the liver: Three cases and literature review.

Multilocular cystic hemangioma is a rare benign tumor classified as an atypical hemangioma. Currently, there are limited imaging reports available, and the imaging characteristics can be challenging to distinguish from other malignant multilocular cystic liver diseases such as cystadenocarcinoma, necessitating confirmation through pathological diagnosis. Here, we discuss the imaging features of 3 cases of multilocular cystic hemangiomas. Case 1 was a 24-year-old young female, and Case 2 involved a 60-year-old elderly male. Both patients were asymptomatic and physical examination revealed hepatic space-occupying lesions. Imaging findings revealed multilocular cystic lesions in the left liver with septa, calcification, a high diffusion-weighted magnetic resonance imaging (DWI) signal at the edge of the lesion, and progressive enhancement of the cyst wall and septa. Case 3 involved a 50-year-old male patient with epigastric distending pain for 1 month and sudden severe abdominal pain for 14 hours. Imaging results revealed a multilocular cystic lesion in the left liver with septa and tumor bleeding, a high DWI signal, and an enhanced cyst wall and septa. The pathological diagnosis confirmed a hepatic hemangioma. All 3 patients underwent liver tumor resection. All 3 patients recovered successfully without any intraoperative or postoperative complications during the follow-up periods of 5 years, 6 months, and 5 months. There were no signs of recurrence. Liver imaging revealed multilocular cystic lesions with features, such as compartmentalization, calcification, or bleeding. Multilocular cystic hemangiomas should be considered in imaging diagnosis. Enhancing our understanding of multilocular cystic hemangiomas can aid in improving the differential diagnosis of other malignant multilocular cystic liver diseases, ultimately reducing unnecessary liver resection.

Clinicopathologic and imaging features of odontogenic myxomas: a multi-institutional study.

This study aims to report clinicopathologic and imaging features of odontogenic myxomas (OM), highlighting uncommon findings. Clinicopathologic and imaging data of OMs diagnosed in the five Brazilian diagnostic pathology centers were collected and analyzed. The series comprised 42 females (68.9%) and 19 males (31.1%), with a 2.2:1 female-to-male ratio and a mean age of 34.5±15.4 years (range: 4-80). Clinically, most OMs presented as painless intraoral swelling (n = 36; 70.6%) in the mandible (n=37; 59.7%). Multilocular lesions (n=30; 83.3%) were more common than unilocular lesions (n=6; 16.7%). There was no statistically significant difference between the average size of unilocular and multilocular OMs (p=0.2431). The borders of OMs were mainly well-defined (n=24; 66.7%) with different degrees of cortication. Only seven tumors caused tooth resorption (15.9%), while 24 (54.5%) caused tooth displacement. Cortical bone perforation was observed in 12 (38.7%) cases. Morphologically, OMs were characterized mainly by stellate or spindle-shaped cells in a myxoid background (n=53; 85.5%). Surgical resection was the most common treatment modality (n=15; 65.2%), followed by conservative surgery (n=8; 34.8%). Outcomes were available in 20 cases (32.3%). Seven of these patients had local recurrence (35%). Enucleation was the treatment with the highest recurrence rate (4/7; 57.1%). OM has a predilection for the posterior region of the jaws of female adults. Despite their bland morphological appearance, they displayed diverse imaging features. Clinicians must include the OM in the differential diagnosis of osteolytic lesions of the jaws. A long follow-up is needed to monitor possible recurrences.

Ovarian endometrioma: a report of a pediatric case diagnosed prior to menstruation

BackgroundOvarian endometriomas (OEs) are rarely found in the pediatric population, especially before menstruation. We report a 6-year-old girl who was postoperatively diagnosed with OE before menstruation.Case presentationA 6-year-old girl presented to a local pediatrician with abdominal pain and vomiting. Abdominal ultrasonography revealed a multilocular cystic lesion to the left of the bladder. Magnetic resonance imaging (MRI) revealed similar findings, with the contents of the cyst showing a low signal on T1-weighted imaging and a high signal on T2-weighted imaging. The patient was referred to our institution for further examination. Enhanced computed tomography (CT) showed a multilocular cystic lesion sized 56 × 44 × 30 mm with partial calcification. The left ovarian vein was dilated, suggesting the origin of the tumor to be the left ovary. Extirpation of the lesion was performed under laparoscopic assistance. Pathological findings indicated an ovarian endometrioma. To our knowledge, this is the youngest report of an OE diagnosed in a patient prior to menstruation.ConclusionsOEs in children before menstruation are extremely rare; thus, the long-term prognosis is yet to be determined.

A Rare Case of Struma Ovarii in Afghanistan

Introduction: Struma ovarii is a rare ovarian tumor characterized by containing either entirely or predominantly thyroid tissue (> 50%). It accounts for less than 1% of all ovarian tumors and approximately 3% of ovarian teratomas. The condition was first described by Von Klden in 1895. Case Presentation: In this report, we described a 50-year-old Afghan menopausal woman who referred to our hospital with a 5-month history of weight loss, anorexia, hyperthyroidism, abdominal distension and sinus tachycardia. Abdominal radiological findings revealed left adnexal large multilocular cystic lesion and the patient’s CA-125 serum level was high. Preoperatively, the clinicians suggested a diagnosis of ovarian cancer based on the symptoms, radiological findings and high level of CA-125 serum. However, postoperatively, histopathological examination revealed the lesion to be a benign struma ovarii. Conclusions: Association of struma ovarii with CA-125 and hyperthyroidism is an extremely rare case and are usually misdiagnosed preoperatively due to nonspecific clinical manifestations, and indistinguishable imaging studies, and should be kept in the differential diagnosis of all ovarian cystic lesions. An exact diagnosis is only made by postoperative histopathological examination, and complete surgical resection of the lesion is considered the optimal treatment.

Ameloblastic fibroma of mandible- A case report

Ameloblastic fibromas are uncommon mixed benign odontogenic tumors with an overall prevalence of less than 5%. Asymptomatic uniloular lesions can be effectively managed with curettage, multilocular lesions require meticulous enucleation to avoid the risk of relapse. We report a case successful management of an asymptomatic multilocular ameloblastic fibroma with 2 years of follow up.

Xanthoma of the Jaw Bones: Cases Series and Review of Literature

BackgroundIntraosseous xanthomas are rare benign lesions sometimes associated with excess lipid production. Xanthoma of the jaw bones (XJB) was first reported in 1964, and fewer than 50 cases have been reported in the English literature to date. The etiopathogenesis of XJB is highly suggestive of a reactive process or a metabolic condition.MethodSeven cases of XJBs were retrieved from the archives of 4 oral and maxillofacial pathology services. Clinical, radiographic and histopathologic features of all these cases were retrospectively analyzed. Immunohistochemical (IHC) stains for S100 and CD68 were performed.ResultsAll seven cases involved the mandible. Patients’ age ranged between 13 and 69 years with an evenly distributed female to male ratio. One patient had a medical history of hyperlipidemia, but the medical and dental histories of the others were unremarkable. For most cases, XJB was an incidental finding discovered during routine radiographic examination. Swelling and cortical expansion were noted in a few cases. Radiographically, cases typically presented as either well-defined multilocular or unilocular lesions, which were either radiolucent or mixed radiolucent/radiopaque. All the lesions were treated with surgical curettage and no recurrence was observed during subsequent follow-ups. Each of the seven cases exhibited sheets of foamy macrophages. The diagnosis is established by exclusion of entities with overlapping microscopic features and involved correlation with the clinical, histological, radiographic and IHC profiles. Immunohistochemically, all the cases expressed diffuse positivity for CD68 and were negative for S100.ConclusionXJB is a rare lesion of unknown etiology, which may mimic other benign or reactive jaw lesions. Due to its rarity and the potential diagnostic challenges it presents, clinicians must remain vigilant and consider CXJ in their differential when assessing radiolucent jaw anomalies.

A Large Adult Postcricoid Lymphatic Malformation: A Case Report and Literature Review.

Adult-onset lymphatic malformations arising at the postcricoid, a subsite of the hypopharynx, are sporadic. Only one case has been previously reported. In this study, we presented a 36-year-old female presented with globus sensation, dysphagia, and upper airway obstruction, requiring a tracheostomy. A computed tomography scan identified a 5 cm × 4.5 cm × 3 cm multilocular hypodense lesion in the postcricoid. Due to its considerable size, complete resection with function preservation was crucial, and a standard microscopic direct laryngoscopy approach may result in inadequate exposure, while an open transcervical approach may affect functional outcomes and increase surgical complications. We successfully performed an en bloc resection with a transoral endoscopic approach, using laryngeal suspension and a laparoscopic ultrasonic scalpel to preserve aerodigestive functions, ensure rapid recovery, and avoid neck scarring. The patient was decannulated within 2 weeks and remained disease-free after 1 year. The reported cases of adult-onset lymphatic malformations at the postcricoid and hypopharynx were reviewed and summarized for educational purposes.

Clinicoradiologic features of ameloblastomas: A single-centre study of 155 cases.

The purpose of the current study was to report on the clinical presentation and radiologic features of 155 cases of ameloblastoma (AB), representing a detailed, large, single-centre radiologic study. Histologically confirmed cases were reviewed over 11 years. Demographic and clinical data were retrieved from the patient's records. Radiologic information was analysed from available radiographs. The radiologic features of ABs were assessed according to the mean age of presentation and the mean duration of the lesion. The distinguishing radiologic features between adults/children and sex were also evaluated. A statistically significant correlation existed between loss of border demarcation and advanced mean age. Multilocular lesions were markedly more common in adults compared to children. Multilocular ABs were associated with increased lesion duration and advanced mean age. Radiologic signs of reactive bony changes associated with the tumour presented at the highest mean duration of all bony effects. Bony expansion and cortical destruction were statistically correlated with lesion duration. Tooth impaction was more common in children. Some mandibular lesions reached a significant size, resulting in impingement of the maxillary sinus, zygoma, orbit and pterygoid plates. Due to unfortunate healthcare access constraints, ABs grow to significant sizes and exhibit features not often reported in the literature. The findings of this analysis highlighted the radiologic features of ABs expressed through the mean age and duration of the lesion. This emphasises the significance of timely management of these lesions.

Pathological Portrait of a Submandibular Gland Lymphoepithelial Cyst in a Non HIV Patient: A Case Report

Lymphoepithelial Cysts (LEC) manifest as benign, unilocular to multilocular lesions predominantly in the head and neck areas. LEC typically localise in the salivary glands, with the parotid gland being more common and the submandibular gland being a rare occurrence. Additionally, they may be observed in the oral cavity, with a particular affinity for the floor of the mouth. It manifests as a painless, solitary cystic mass situated close to or within the salivary gland. It predominantly occurs in individuals infected with Human Immunodeficiency Virus (HIV). It typically arises as a consequence of lymphocyte-induced dilation of the cystic duct, and in accordance with index case, the definitive diagnosis is consistently confirmed through postoperative histopathological examination. They are infrequently observed in immunocompetent individuals and may have a connection to Sjögren’s syndrome. Numerous contemporary investigative methods are at our disposal, with Fine Needle Aspiration Cytology (FNAC) emerging as a swift diagnostic tool for promptly confirming a LEC. Additional diagnostic modalities encompass Ultrasonography (USG) and Computed Tomography (CT). The primary treatment for an LEC continues to be surgical intervention. Understanding the characteristics and behaviour of such cysts in non HIV patients is critical for accurate diagnosis, appropriate therapy, and, perhaps, enhancing the understanding of the spectrum of conditions associated with these cyst formations. Investigating LEC occurring in the rare location of the submandibular salivary gland, this work is distinctive in that it involves an immunocompetent individual. The present case is of a 42-year-old woman who elucidates the diagnostic pathway, encompassing both FNAC and histopathology.

Ameloblastic fibro-dentinoma: a rare mixed odontogenic tumor case report with review of literature

BackgroundAmeloblastic fibro-dentinoma is considered a rare, benign, mixed odontogenic tumor that occurs mainly in the posterior mandible in the 1st–2nd decade of life. Although the clinical behavior of Ameloblastic fibro-dentinoma is similar to that of ameloblastic fibroma, there is a debate about whether Ameloblastic fibro-dentinoma is a developing hamartomatous odontoma or a separate neoplastic odontogenic tumor like ameloblastic fibroma. However, it is important to understand the histopathogenesis of this rare tumor.Case presentationA case report presenting an 11-year-old male child with a swelling in the posterior mandible. Radiographic examination revealed a multilocular lesion with mixed radiodensity related to the impacted lower left second premolar tooth. Incisional biopsy was done, and microscopic examination revealed cords and nests of odontogenic follicles lined by ameloblast-like cells and central stellate reticulum-like cells in the primitive ecto-mesenchymal stroma with areas of dentinoid material and osteodentin. The diagnosis was ameloblastic fibro-dentinoma. Surgical excision of the lesion was done, and the patient was followed up for 1 year without evidence of recurrence.ConclusionReporting such a rare entity clarifies the debate about its nature and the importance of early diagnosis of lesions that are associated with unerupted teeth showing how it is effective in early management and prognosis.

Adrenal Cystic Lymphangioma with Radiological, Clinical and Histopathological Findings, Case report.

Cystic lymphangiomas are benign lesions originating from lymphatic endothelial cells. It occurs due to developmental anomalies of lymphatic vessels. They are usually localized in the head and neck region. Cystic lymphangiomas of adrenal origin are very rare. This presentation aims to report a case of left-sided adrenal cystic lymphangioma detected incidentally on radiological examination due to abdominal pain, with clinical, radiological, and pathological findings. A 65-year-old female patient was admitted to our clinic with abdominal pain. In the abdominal examination, the pain was detected in the epigastric region and left the upper quadrant with palpation. No pathology was observed in the complete blood count and biochemical parameters, except for a CRP elevation of 10.2 mg/dL. In examination with ultrasonography (US), in the left upper quadrant of the abdomen, in the localization of the adrenal gland, a multilocular cystic lesion with partially dense contents, which is not vascularised by Doppler US, containing thin echogenic septa was detected. Enhanced contrast multidetector computed tomography was performed to determine the nature and characterization of the mass. A 60x57 mm cystic lesion with multi-lobulated contour and fluid density was defined in the left adrenal gland. The patient was diagnosed with cystic lymphangioma radiologically and was operated upon due to symptoms and size. Pathological diagnosis was reported as cystic lymphangioma. Preoperative clinical and radiological correct diagnosis is critical because the treatment approach and prognosis may differ from other adrenal tumors or cysts.

A rare case report of multiple calculi in an adult female having cystic nephroma

A benign multilocular cyst is a benign, nondysplastic, neoplastic lesion that occurs most commonly either before the age of 4 years in males or after the age of 30 years in females. The only way to determine the diagnosis of a multilocular cystic lesion is by surgical excision. We report a case of 50 years old female with chronic left flank pain. After imaging like Ultrasonography, Intravenous pyelography, patient underwent nephrolithotomy with deroofing of the cyst under the impression of multiple renal calculi within a renal cyst. Histopathological examination showed that it was a multilocular cystic nephroma, a rare benign neoplasm of the kidney. This case report discusses the epidemiology, clinical presentation, radiological features, differential diagnosis and histopathology of this neoplasm.

Mandibular Ramusun Ewing Sarkomu: Olgu Sunumu

Since Ewing sarcomas are highly aggressive tumors, early diagnosis is very important for the prognosis of these patients. The aim of this case report is to raise awareness among pediatricians and dentists about the clinical, radiological and histopathological features of these aggressive tumors. A 10-year-old child patient referred to our clinic from the ENT outpatient clinic was found to have a sore throat that had been persisting for about 2-3 months. In addition, it was observed that there was an extraoral swelling in the right mandibular ramus region that had started to be noticed extraorally for the last 15 days. Panoramic radiography revealed a multilocular lesion involving the mandibular ramus. The lesion was also evaluated by conventional CT, MR and ultrasonography. The biopsy specimen obtained from the patient was examined histopathologically and diagnosed as Ewing's Sarcoma and treatment with chemotherapy was started by the Department of Pediatric Oncology.The oral findings of ewing sarcomas, which rarely affect the mandibular region, should always be considered for the possibility of confusion with periodontal diseases, odontogenic and pericoronal infections. Therefore, additional and appropriate radiographic examinations should be used to make a definitive diagnosis.

WITHDRAWN: A multilocular discal cyst extending from the spinal canal to the extraforaminal region: A case report

Lumbar discal cysts are intraspinal extradural cysts communicating with the intervertebral disc. The usual location and morphology are in the caudal ventrolateral epidural space of the spinal canal, without extension to the neural foramen or crossing the midline and described as a well-defined homogeneous oval or spherical cyst on low and high signal intensities observed in lumbar lesions on T1- and T2-weighted magnetic resonance imaging, respectively. We report an unusual lumbar discal cyst in terms of the lesion location and morphology. A 33-year-old-man presented with lower back and right anterior thigh pain. Magnetic resonance imaging revealed multilocular cystic lesions in the cranial ventrolateral epidural space at L2-L3 with low and high signal intensities on T1- and T2-weighted magnetic resonance imaging, respectively. We performed a full-endoscopic transforaminal cystectomy under general anesthesia. Lumbar discal cysts should be considered a differential diagnosis for multilocular intraspinal cystic lesion.

RESECTION OF AMELOBASTOMA AND IMMEDIATE RECONSTRUCTION WITH MICROVASCULARIZED FIBULAR GRAFT: A CASE REPORT

A 35-year-old female presented an intraoral swelling in the right posterior region of the mandible, which was asymptomatic, with two years of evolution. She presented an anatomopathological report with a previous diagnosis of ameloblastoma, but she was unable complete the proposed treatment due to the COVID-19 pandemic. Clinical examination revealed a granulomatous lesion in the right retromolar region, extending to the vestibular mucosa of elements 46 and 47, together with,bone expansion. A facial tomography showed an expansive, cystic, multilocular lesion, with erosion of the adjacent cortical bone in the right body, angle, and mandibular ramus, measuring approximately 4.6 × 2.2 × 3.7 cm. The patient underwent partial resection of the right posterior mandible with immediate reconstruction of a microvascularized fibular graft and fixation with a reconstruction plate. In the postoperative period, the patient evolved with satisfactory mandibular contour, good mouth opening, and preserved masticatory function. A 35-year-old female presented an intraoral swelling in the right posterior region of the mandible, which was asymptomatic, with two years of evolution. She presented an anatomopathological report with a previous diagnosis of ameloblastoma, but she was unable complete the proposed treatment due to the COVID-19 pandemic. Clinical examination revealed a granulomatous lesion in the right retromolar region, extending to the vestibular mucosa of elements 46 and 47, together with,bone expansion. A facial tomography showed an expansive, cystic, multilocular lesion, with erosion of the adjacent cortical bone in the right body, angle, and mandibular ramus, measuring approximately 4.6 × 2.2 × 3.7 cm. The patient underwent partial resection of the right posterior mandible with immediate reconstruction of a microvascularized fibular graft and fixation with a reconstruction plate. In the postoperative period, the patient evolved with satisfactory mandibular contour, good mouth opening, and preserved masticatory function.

BILATERAL ORTHOKERATINED ODONTOGENIC CYST: A REPORT OF TWO NEW CASES

Orthokeratinized odontogenic cyst (OOC) is an uncommon developmental cyst of the jaws that usually occur singly, as a unilocular radiolucency affecting the posterior mandible of males. Bilateral OCCs are exceedingly rare, with less than 10 cases reported in the literature. Our study presents two new cases of bilateral OOCs. The first patient was an 18-year-old man who presented two bilateral well-circumscribed unilocular radiolucent lesions in the posterior mandible. The second patient was a 29-year-old woman with bilateral well-circumscribed unilocular (left) and multilocular (right) radiolucent lesions, located in the posterior mandible. The unilocular lesions were associated with unerupted lower molars. Microscopically, the cysts were entirely lined by orthokeratinized stratified squamous epithelium, confirming the diagnosis of OOC. Both patients were treated conservatively, and to date, no recurrence was evident. Clinicians should consider OOC during the evaluation of bilateral pericoronal radiolucent lesions in the posterior mandible of young adults. Orthokeratinized odontogenic cyst (OOC) is an uncommon developmental cyst of the jaws that usually occur singly, as a unilocular radiolucency affecting the posterior mandible of males. Bilateral OCCs are exceedingly rare, with less than 10 cases reported in the literature. Our study presents two new cases of bilateral OOCs. The first patient was an 18-year-old man who presented two bilateral well-circumscribed unilocular radiolucent lesions in the posterior mandible. The second patient was a 29-year-old woman with bilateral well-circumscribed unilocular (left) and multilocular (right) radiolucent lesions, located in the posterior mandible. The unilocular lesions were associated with unerupted lower molars. Microscopically, the cysts were entirely lined by orthokeratinized stratified squamous epithelium, confirming the diagnosis of OOC. Both patients were treated conservatively, and to date, no recurrence was evident. Clinicians should consider OOC during the evaluation of bilateral pericoronal radiolucent lesions in the posterior mandible of young adults.

DESMOPLASTIC FIBROMA OF GNATHIC BONES: A SYSTEMATIC REVIEW

Objective To analyze the available data regarding desmoplastic fibroma (DF) into a systematic review to integrate the demographic, clinical and histopathological features, treatment, and recurrence of this condition. Study Design The present study was conducted based on PRISMA statement. An electronic search was undertaken in August 2021 in four databases. The eligibility criteria were restricted to case reports, case series. and cross-sectional studies. Results Eighty-one articles met the eligibility criteria, yielding 125 cases of DF. Women (60.8%) were more affected, with a mean age of 19.1 years (SD±16.7). In relation to the anatomical site, 69.4% lesions were found in posterior mandible, with a bulging tumor clinical appearance. Most lesions were asymptomatic (85.9%) with a mean evolution time of 11 months. Radiologically, the tumor is described as a radiolucent (92,4%) multilocular (70.5%) lesion, presenting defined borders (35.5%) as well as causing bone expansion (28.2%). Resection (53.1%) and enucleation (14.3%) were the treatment choice in most cases. Recurrence was observed in 11.6% of the cases, with resection being the treatment of choice (100%). Conclusion DF is a rare bone tumor with a challenging diagnosis and treatment. This study provides information that could be helpful for the diagnosis and management of this condition. To analyze the available data regarding desmoplastic fibroma (DF) into a systematic review to integrate the demographic, clinical and histopathological features, treatment, and recurrence of this condition. The present study was conducted based on PRISMA statement. An electronic search was undertaken in August 2021 in four databases. The eligibility criteria were restricted to case reports, case series. and cross-sectional studies. Eighty-one articles met the eligibility criteria, yielding 125 cases of DF. Women (60.8%) were more affected, with a mean age of 19.1 years (SD±16.7). In relation to the anatomical site, 69.4% lesions were found in posterior mandible, with a bulging tumor clinical appearance. Most lesions were asymptomatic (85.9%) with a mean evolution time of 11 months. Radiologically, the tumor is described as a radiolucent (92,4%) multilocular (70.5%) lesion, presenting defined borders (35.5%) as well as causing bone expansion (28.2%). Resection (53.1%) and enucleation (14.3%) were the treatment choice in most cases. Recurrence was observed in 11.6% of the cases, with resection being the treatment of choice (100%). DF is a rare bone tumor with a challenging diagnosis and treatment. This study provides information that could be helpful for the diagnosis and management of this condition.

BROWN TUMORS IN THE JAWS AS THE FIRST CLINICAL SIGN OF HYPERPARATHYROIDISM

Brown tumor of hyperparathyroidism is a bone lesion that results from abnormal bone metabolism. Our study describes a case of a 26-year-old man presenting clinically facial deformity and bone expansion in the jaws. Cone-beam computed tomography exhibited an expansive, ill-defined multilocular hypodense lesion in the maxilla, and a well-defined unilocular hypodense lesion in the mandible. Medical history was not contributive. An incisional biopsy was done, and histopathological analysis of both lesions displayed abundant osteoclast-type multinucleated giant cells intermingled with ovoid and spindle-shaped mononuclear cells in a fibrovascular background, suggestive of central giant cell lesions. Laboratory examination revealed elevated serum levels of parathyroid hormone and calcium, and a decreased level of phosphorus. Based on clinical, radiologic, microscopic, and biochemical findings, the diagnosis was brown tumor of hyperparathyroidism. The patient had undergone excision of right lower parathyroid and had a partially significant reduction in the jaws’ tumors after 6 months of follow-up. Brown tumor of hyperparathyroidism is a bone lesion that results from abnormal bone metabolism. Our study describes a case of a 26-year-old man presenting clinically facial deformity and bone expansion in the jaws. Cone-beam computed tomography exhibited an expansive, ill-defined multilocular hypodense lesion in the maxilla, and a well-defined unilocular hypodense lesion in the mandible. Medical history was not contributive. An incisional biopsy was done, and histopathological analysis of both lesions displayed abundant osteoclast-type multinucleated giant cells intermingled with ovoid and spindle-shaped mononuclear cells in a fibrovascular background, suggestive of central giant cell lesions. Laboratory examination revealed elevated serum levels of parathyroid hormone and calcium, and a decreased level of phosphorus. Based on clinical, radiologic, microscopic, and biochemical findings, the diagnosis was brown tumor of hyperparathyroidism. The patient had undergone excision of right lower parathyroid and had a partially significant reduction in the jaws’ tumors after 6 months of follow-up.